In fact, isolated multinucleated giant cells
are more common (Figure 8, B).
Caption: Figure 5: Pathology specimens showing a nodule of amorphous debris and fibrinous material in low-power field (a) and histiocytes and multinucleated giant cells
in high-power field (b).
(a) Granulomatous inflammation with eosinophils and multinucleated giant cells
in the subcutaneous tissue.
Two independent pathologists examined the slides; a three-grade semiquantitative scale for positivity was used: 0, negative; 1, faint positive (positivity evident when slides were examined with 40x); 2, intense positive (positivity evident when slides were examined with 10x) no matter the number of positive cells; the positivity was recorded for mesenchymal cells (fibroblasts and fibrocytes), endothelial cells, macrophages, and, when present, multinucleated giant cells
. The level of positivity was interpreted in correlation with gender, localization, presence of residual tumor, and age of the scar.
(1,3,7) An important element on analysis is the presence or absence of multinucleated giant cells
. In the current case, no giant cells were visualized.
These sinusoidal spaces were bordered by few multinucleated giant cells
. Fibrocellular stroma shows plenty of small cystic spaces filled with blood elements and extravasated blood elements (figures 1-6).
Microscopy revealed many cyst spaces lined by macrophages and occasional multinucleated giant cells
, predominantly in the subserosal layers.
Fibrosis was found in 43.3% of cases, multinucleated giant cells
were found in 3.33%, antral metaplasia was found in 27.73%, and cholesterol clefts were seen in 15.15%.
Granulomatous inflammation is a distinctive pattern of chronic inflammation in response to various infectious agents, such as mycobacteria or fungi, to noninfectious agents, as exemplified in the foreign body reaction (FBR) to biomaterials and in conditions from unknown causes including vasculitis, sarcoidosis, and Wegener's granulomatosis; predominant cells in granulomatous inflammation include macrophages, epithelioid cells, and multinucleated giant cells
Histopathologic examination of tissue biopsy revealed lymphohistiocytic noncaseating granulomatous inflammation with multinucleated giant cells
, consistent with sarcoidosis (Figure 5).
Some parts of tissue show myxoid areas with delicate fibers and stellate shaped cells; multinucleated giant cells
are also visible (Figure 6).
The major differential diagnosis is giant cell carcinoma of lung, since both malignancies are composed of a dimorphic population of polygonal mononucleated and pleomorphic, multinucleated giant cells
. Some authors considered that the presence of predominant tumor multinucleated giant cells
in tumor tissue as a diagnostic feature for a primary lung choriocarcinoma and sheets of polygonal mononucleated tumor cells with scattered giant cells as a feature of giant cell carcinoma of lung .